Mood Disorders
Mood Disorders
A. Mood Episodes
1. Major Depressive Episode (video)
2. Manic Episode (video)
3. Hypomanic episode
4. Mixed Episode
B. Mood Disorders
1. Major Depressive Disorder
a. recurrent vs single episode
b. bereavement
2. Dysthymic Disorder
3. Bipolar I Disorder (BP I)
4. BP II Disorder
5. Cyclothymic Disorder
6. Mood disorder NOS
7. Mood Disorder due to GMC
8. Mood Disorder that is substance induced
C. Other terminology
1. unipolar disorder
2. manic depression
3. double depression
D. Specifiers for mood disorder severity, type, & course
a. severity
1. mild
2. moderate
3. severe
without psychotic features
with psychotic features
mood congruent
mood incongruent
b. type
1. chronic
2. catatonic
3. melancholic
4. atypical
5. postpartum onset
different from “postpartum blues” that is normal reaction to giving 50-80% women
c. course
1. seasonal pattern
Seasonal Affective Disorder (SAD) is not actual DSM dx
2. rapid cycling
E. Etiology
1. Psychological
a. Cognitive explanations
• Schema
Learned helplessness: lack of control over outcomes
Learned hopelessness: helplessness over outcomes + negative life events
• Cognitive triad
Self
World
Future
• Automatic thoughts
• Attributional style
negative outcomes: internal, stable, & global
positive outcomes: external, unstable, specific
• Hypothesis testing
b. Behavioral explanations
• Low rewards and associated drop in operants (i.e., behaviors) to obtain rewards
c. Interpersonal explanations
• Interpersonal loss
• Interpersonal deficits
• Interpersonal role transition
• Interpersonal role dispute
2. Sociocultural
• Gender differences (slide re: epidemiology)
Poverty
Socialized sex role expectations
3. Biological
a. genetic vulnerability (slide re: epidemiology)
• Family studies
• Twin studies
b. neurotransmitters
• 5HT
• NE
• DA
c. endocrine system
• Elevated cortisol
50% pts do not show suppression for
dexamethasone suppression test (DST)
F. Treatment of mood disorders
a. psychological
• Behavioral
• Cognitive
• Interpersonal
b. biological
• Antidepressants
• ECT
• TMS
c. special considerations for BPD
Li and anti-seizure (mood stabilizer) medications
G. Suicide predictors
• Hopelessness
• Gender
• Ideation
• Plan
Time
Place
Method
• Precautions to avoid discovery
• Personal or family history of attempt
• Substance use involved
H. Crisis Situations
• Assess risk factors
• Introduce hope for future
• Help generate alternative solutions to the problem(s)
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